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'''Target-controlled infusion''' ('''TCI''') automates the dosing of intravenous drugs during surgery.  After the [[anesthetist]] sets the desired parameters in a computer and presses the start button, the system controls the [[infusion pump]], while being monitored by the anesthetist.<ref name="AbsalomGlen2016">((cite journal|last1=Absalom|first1=Anthony R.|last2=Glen|first2=John (Iain) B.|last3=Zwart|first3=Gerrit J. C.|last4=Schnider|first4=Thomas W.|last5=Struys|first5=Michel M. R. F.|title=Target-Controlled Infusion|journal=Anesthesia & Analgesia|volume=122|issue=1|year=2016|pages=70–78|issn=0003-2999|doi=10.1213/ANE.0000000000001009|pmid=26516798 |s2cid=41023659 |doi-access=free))</ref>  TCI is as safe and effective as manually controlled infusion.<ref name="pmid10389558">((cite journal |vauthors=Hunt-Smith J, Donaghy A, Leslie K, Kluger M, Gunn K, Warwick N |title=Safety and efficacy of target controlled infusion (Diprifusor) vs manually controlled infusion of propofol for anaesthesia |journal=[[Anaesth Intensive Care]] |volume=27 |issue=3 |pages=260–4 |date=June 1999 |pmid=10389558 |doi= 10.1177/0310057x9902700306|url=http://www.aaic.net.au/PMID/10389558 |accessdate=2018-06-28|doi-access=free ))</ref><ref name="Schraag2001">((cite journal|last1=Schraag|first1=Stefan|title=Theoretical basis of target controlled anaesthesia: history, concept and clinical perspectives|journal=Best Practice & Research Clinical Anaesthesiology|volume=15|issue=1|year=2001|pages=1–17|issn=1521-6896|doi=10.1053/bean.2001.0132))</ref>

TCI can be sub-classified according to the '''target'''. The suffix 'e' as in '''TCIe''' indicates that the target is the effect site, in most cases, the central nervous system or brain. Alternatively, the suffix 'p' denotes plasma, indicating that the device implementing the TCI model is to target the blood plasma. There are important differences in relation to the time taken for [https://derangedphysiology.com/main/cicm-primary-exam/required-reading/pharmacokinetics/Chapter%20333/effect-site-equilibration effect site equilibration]. Studies have demonstrated the clinical safety of the effect-site target model.<ref>((cite journal |title=Comparison of plasma compartment versus two methods for effect compartment--controlled target-controlled infusion for propofol |journal=Anesthesiology |date=February 2000 |volume=92 |issue=2 |pages=399–406 |pmid=10691226 |url=https://pubmed.ncbi.nlm.nih.gov/10691226/|last1=Struys |first1=M. M. |last2=De Smet |first2=T. |last3=Depoorter |first3=B. |last4=Versichelen |first4=L. F. |last5=Mortier |first5=E. P. |last6=Dumortier |first6=F. J. |last7=Shafer |first7=S. L. |last8=Rolly |first8=G. |doi=10.1097/00000542-200002000-00021 |s2cid=36108017 ))</ref>((more citations needed|date=June 2018))

Popular TCI models exist for [[Propofol]] and the synthetic opioid [[Remifentanil]]. The models are based on [[Pharmacokinetics|pharmacokinetic]] studies and use software embedded in the [[infusion device]]. For [[propofol]] the Marsh and Schnider models are available and the Minto model is commonly used for [[remifentanil]]. In 2017, a project to emulate the TCI models in the [[Python_(programming_language)|python]] language was published on [https://github.com/JMathiszig-Lee/PyTCI GitHub]. 
  

==History==
TCI has been used in clinical settings since 1996, initially with [[propofol]].<ref name="pmid26516804">((cite journal |vauthors=Struys MM, De Smet T, Glen JI, Vereecke HE, Absalom AR, Schnider TW |title=The History of Target-Controlled Infusion |journal=[[Anesth. Analg.]] |volume=122 |issue=1 |pages=56–69 |date=January 2016 |pmid=26516804 |doi=10.1213/ANE.0000000000001008 |s2cid=39391491 |url=http://Insights.ovid.com/pubmed?pmid=26516804 |accessdate=2018-06-29))</ref>

==See also==
*[[General anaesthesia#tci]]

==References==
((reflist))

[[Category:Drug delivery devices]]
[[Category:General anesthetics]]


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